Deep Capillary Plexus Vessel Density May Predict Visual Recovery After Retinal Detachment Surgery

Vessel density (VD) in the deep capillary plexus (DCP) may predict visual recovery after successful rhegmatogenous retinal detachment (RRD) surgery, according to research published in Ophthalmology Retina.

Researchers retroscopically reviewed the records of 74 patients (77% men, mean age 60.3±10.4 years at RRD onset) who underwent successful surgery (single scleral buckling or pars plana vitrectomy) for RRD at a single center. They used optical coherence tomography angiography (OCTA) to measure foveal avascular zone (FAZ) area in the superficial capillary plexus (SCP) as well as VD in the SCP, deep capillary plexus (DCP) and choriocapillary plexus (CCP). After surgery, the patients completed an eye exam within 1 week, at 1 month, and at 6 months. The team used patients’ contralateral eyes as controls. 

Overall, median retinal detachment (RD) extended into 2.0 quadrants. Macular involvement appeared in 60% of cases, and grade B proliferative vitreoretinopathy (PVR) presented in 35% of cases.

Investigators noted that mean VD significantly decreased in the DCP in eyes that underwent RRD surgery after 1 month (P =.019), but improved to the values of the contralateral eyes by 6-month follow up. The team also observed an association between VD in the DCP and best corrected visual acuity (BCVA)(P =.009). Mean BCVA improved between 1 month and 6 months following surgery (0.3 logMAR and 0.1 logMAR, respectively). Lower 1-month VD in the DCP trended toward worse final BCVA (P =.067), according to the report.

Researchers also noted that median foveal avascular zone (FAZ) decreased from 2.3 mm² at 1 month to 2.2 mm² at 6 months (P =.029) and median VD increased in theSCP, DCP, and CCP (P =.021, P =.015, and P =.034, respectively).

“VD in the DCP decreased in RRD eyes, but gradually improved over time to reach the value of unaffected fellow eyes,” according to the investigators. “It was associated with postoperative BCVA, as well as with the restoration of photoreceptor layers, thus suggesting that it might also serve as a predictor for visual recovery following successful RRD surge.”

Study limitations include a retrospective nature, single center design, short follow-up duration, and inability to measure FAZ area in the DCP.

Reference

Stoebener S, Salleron J, Zessler A, et al. Association of microvasculature changes with visual outcomes after successful retinal detachment surgery. Ophthalmol Ret. Published online May 4, 2022. doi:10.1016/j.oret.2022.04.020